Soft tissue reconstruction strategy for sacral tumor resection.
10.3760/cma.j.cn112139-20220519-00230
- VernacularTitle:骶骨肿瘤切除术后软组织重建的策略和效果
- Author:
Mo SHA
1
;
Zhen Qi DING
1
;
Hai Sen HONG
1
;
Kai NIE
2
;
Xia Cong LIN
3
;
Jian Chuan SHAO
4
;
Wei SONG
1
;
Liang Q KANG
1
Author Information
1. Orthopedic Center of People's Liberation Army, the 909th Hospital, Dongnan Hospital of Xiamen University, Zhangzhou 363000, China.
2. Department of General Surgery, the 909th Hospital, Dongnan Hospital of Xiamen University, Zhangzhou 363000, China.
3. Department of Urology, the 909th Hospital, Dongnan Hospital of Xiamen University, Zhangzhou 363000, China.
4. Department of Plastic Surgery, the 909th Hospital, Dongnan Hospital of Xiamen University, Zhangzhou 363000, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Retrospective Studies;
Postoperative Complications;
Neoplasms
- From:
Chinese Journal of Surgery
2022;60(12):1085-1092
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the clinical strategy and effect of soft tissue reconstruction after sacral tumor resection in different planes. Methods: The data of 27 consecutive patients who underwent primary or secondary sacral tumor resection and soft tissue reconstruction from June 2012 to June 2021 at Dongnan Hospital of Xiamen University (the 909th Hospital) were retrospectively analyzed. There were 11 males and 16 females, aged (M(IQR)) (46.2±23.6) years (range: 16 to 72 years). Sacrospinous muscle, gluteus maximus and vertical rectus abdominis muscle flap were selected for soft tissue reconstruction according to the tumor site and the size of tissue defect. the postoperative follow-up was performed. The operative methods, intraoperative conditions, complications and disease outcomes were summarized. Results: Among the 27 patients with sacral tumor, the tumor plane was located in S1 in 8 cases, S2 in 5 cases and S3 or below in 14 cases. There were 12 patients with tumor volume≤400 cm3 and 15 patients with tumor volume>400 cm3. Operation time was 100(90) minutes (range: 70 to 610 minutes), intraoperative blood loss was 800(1 600) ml (range: 400 to 6 500 ml). Soft tissue reconstruction was performed by transabdominal rectus abdominis transfer repair in 2 cases, extraperitoneal rectus abdominis transfer repair in 1 case, gluteus maximus transfer repair in 5 cases, gluteus maximus advancement repair in 13 cases, and sacrospinous muscle transfer repair in 6 cases. Postoperative complications occurred in 6 cases, including 1 case of incision infection, 4 cases of skin border necrosis, and 1 case of delayed infection due to fracture of internal fixator 3 years after operation, all of them were cured. The follow-up time was (35±21) months. Among the patients, 6 patients had recurrence, 2 patients with Ewing sarcoma died of lung metastasis 1 year after operation, 4 patients with metastatic cancer died of primary disease, and the remaining patients survived without disease. Conclusion: Choosing different soft tissue reconstruction strategies according to sacral tumor location and tissue defect size can effectively fill the dead space after sacral tumor resection, reduce postoperative complications and improve the prognosis of patients.
